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PubMed1995

[One hundred twenty years of China's health quarantine service].

China's health quarantine service, initiated in 1873, has experienced a long way of 120 years. This article focuses on the rapid development of all aspects in the quarantine construction of organization, profession and ideology, especially in P. R. China's period of reform. The number of quarantine service has increased from 17 seaport services to 192 services, including seaport, airport and land frontier services (up to the end of 1992). The professional quarantine works has expanded from simple quarantine inspection to comprehensive surveillance of communicable diseases, vector control, imported foodstuff supervision and examination etc. Significant contributions have been made to the prevention of the transmission of communicable diseases into the territory, the improvement of the sanitary condition of frontier ports and means of transportation. Frontier health quarantine is one of the strongest lookout posts of sanitation door of the country. It has become one of the major branches of preventive medicine and one of the key links of international health care cooperation. Health quarantine is being developing and strengthening for new and greater success for the realizatiion of the socialist modernization of our country.

China↗
PubMed2003

Simulating the effect of quarantine on the spread of the 1918-19 flu in central Canada.

Quarantine is often proposed and sometimes used to control the spread of infectious diseases through a human population. Yet there is usually little or no information on the effectiveness of attempting to quarantine humans that is not of an anecdotal or conjectural nature. This paper describes how a compartmental model for the geographic spread of infectious diseases can be used to address the potential effectiveness of human quarantine. The model is applied to data from the historical record in central Canada around the time of the 1918-19 influenza epidemic. Information on the daily mobility patterns of individuals engaged in the fur trade throughout the region prior to, during, and immediately after the epidemic are used to determine whether rates of travel were affected by informal quarantine policies imposed by community leaders. The model is then used to assess the impact of observed differences in travel on the spread of the epidemic. Results show that when mobility rates are very low, as in this region, quarantine practices must be highly effective before they alter disease patterns significantly. Simulation results suggest, though, that effectiveness varies depending on when the limitation on travel between communities is implemented and how long it lasts, and that a policy of introducing quarantine at the earliest possible time may not always lead to the greatest reduction in cases of a disease.

Computer Simulation↗
PubMed2005

The economic impact of quarantine: SARS in Toronto as a case study.

OBJECTIVES: Over time, quarantine has become a classic public health intervention and has been used repeatedly when newly emerging infectious diseases have threatened to spread throughout a population. Here, we weigh the economic costs and benefits associated with implementing widespread quarantine in Toronto during the SARS outbreaks of 2003. METHODS: We compared the costs of two outbreak scenarios: in Scenario A, SARS is able to transmit itself throughout a population without any significant public health interventions. In Scenario B, quarantine is implemented early on in an attempt to contain the virus. By evaluating these situations, we can investigate whether or not the use of quarantine is justified by being either cost-saving, life saving, or both. RESULTS: Our results indicate that quarantine is effective in containing newly emerging infectious diseases, and also cost saving when compared to not implementing a widespread containment mechanism. CONCLUSIONS: This paper illustrates that it is not only in our humanitarian interest for public health and healthcare officials to remain aggressive in their response to newly emerging infections, but also in our collective economic interest. Despite somewhat daunting initial costs, quarantine saves both lives and money.

Canada↗
PubMed2006

When is quarantine a useful control strategy for emerging infectious diseases?

The isolation and treatment of symptomatic individuals, coupled with the quarantining of individuals that have a high risk of having been infected, constitute two commonly used epidemic control measures. Although isolation is probably always a desirable public health measure, quarantine is more controversial. Mass quarantine can inflict significant social, psychological, and economic costs without resulting in the detection of many infected individuals. The authors use probabilistic models to determine the conditions under which quarantine is expected to be useful. Results demonstrate that the number of infections averted (per initially infected individual) through the use of quarantine is expected to be very low provided that isolation is effective, but it increases abruptly and at an accelerating rate as the effectiveness of isolation diminishes. When isolation is ineffective, the use of quarantine will be most beneficial when there is significant asymptomatic transmission and if the asymptomatic period is neither very long nor very short.

Communicable Diseases, Emerging↗
PubMed2005

Risk perception and compliance with quarantine during the SARS outbreak.

PURPOSE: To explore the experience of being on quarantine for severe acute respiratory syndrome (SARS) with a focus on the relationship between perceived risk of contracting SARS and reported compliance with the quarantine order and protocols. DESIGN: Descriptive, qualitative. METHODS: Semi-structured interviews were conducted with people who had been quarantined during the SARS outbreak in Toronto in 2003. Data analysis was completed using an iterative and collaborative approach of reading and re-reading the transcribed interviews, identifying common themes, and comparing and contrasting the data. FINDINGS: To varying extents, participants wavered between fear and denial about their risk of contracting or spreading SARS. Reported compliance with the actual quarantine order was high. However, within households quarantine protocols were followed unevenly. CONCLUSIONS: This research indicates the need for greater credibility in public health communications to increase compliance with quarantine protocols and to contain outbreaks of new and deadly infectious diseases.

Adolescent↗
PubMed2004

SARS control and psychological effects of quarantine, Toronto, Canada.

As a transmissible infectious disease, severe acute respiratory syndrome (SARS) was successfully contained globally by instituting widespread quarantine measures. Although these measures were successful in terminating the outbreak in all areas of the world, the adverse effects of quarantine have not previously been determined in a systematic manner. In this hypothesis-generating study supported by a convenience sample drawn in close temporal proximity to the period of quarantine, we examined the psychological effects of quarantine on persons in Toronto, Canada. The 129 quarantined persons who responded to a Web-based survey exhibited a high prevalence of psychological distress. Symptoms of posttraumatic stress disorder (PTSD) and depression were observed in 28.9% and 31.2% of respondents, respectively. Longer durations of quarantine were associated with an increased prevalence of PTSD symptoms. Acquaintance with or direct exposure to someone with a diagnosis of SARS was also associated with PTSD and depressive symptoms.

Adolescent↗
PubMed1998

Rodent quarantine programs: purpose, principles, and practice.

In animal research, validity and reproducibility of data are critically influenced by the microbial status of the experimental animals. One of the most crucial aspects of assuring quality in animal research is providing research personnel with confidence that experimental results will not be invalidated due to interference caused by infectious disease. An effective quarantine program is essential to providing this assurance. Quarantine programs are generally instituted to prevent the introduction of rodent pathogens into established specific-pathogen-free colonies in a facility. Therefore, programs should be designed to isolate newly acquired rodents until their health status can be determined and to maximize the probability that microorganisms of interest will be detected before the animals are introduced into (and thus, could potentially contaminate) established colonies. Important principles that are critical to designing an effective quarantine program will be discussed here, as will the practical implementation of these principles. Although quarantine programs may be costly in terms of time and effort, these costs must be balanced against the potential costs of disease outbreaks that could invalidate long-term studies, alter normal biological baselines, and cause the loss or necessitate re-derivation of rare or valuable strains of rodents. Reducing the incidence of quarantine failures through appropriate program design and implementation helps to maintain the confidence of research personnel in the value of quarantine programs and in our competence as specialists in laboratory animal management and as partners in the research process.

Animal Husbandry↗
PubMed2002

Use of microisolator caging in a risk-based mouse import and quarantine program: a retrospective study.

The expanding use of genetically engineered mice has placed increasing demands upon research facilities to import mutant strains from noncommercial sources. Conventional quarantine strategies use relatively large amounts of space per animal and/or require specialized equipment (e.g., cubicles, isolators, and ventilated racks). We have retrospectively assessed a quarantine program instituted 4 years ago that used a small amount of space and minimized the need for special equipment. Shipments presumed, in light of health reports, to be free of agents excluded from our colonies were housed in static microisolator caging in a shared quarantine room. Rather than functioning as an "all-in-all-out" area, the room continually received new shipments, which were released intermittently as multi-shipment groups after testing was performed. Noninvasive testing of the imported mice was combined with nonsurvival sampling of sentinels that had been exposed to shipped animals via direct contact and/or exposure to soiled bedding. During the 4-year period examined, the vast majority of shipments presumed to be free of excluded agents showed no evidence of contamination when screened. When active infection was detected in the shared room, the procedures in place proved sufficient to prevent cross-contamination of other shipments. The use of sentinel animals to detect the shedding of infectious agents during quarantine was found to be an effective strategy that minimized the potential impact of invasive testing on quarantined animals. Although the program we describe is not appropriate for all situations, this type of approach may be considered by institutions wishing to explore alternatives to conventional quarantine strategies during periods of restricted space availability.

Animal Husbandry↗
PubMed2003

Efficiency of quarantine during an epidemic of severe acute respiratory syndrome--Beijing, China, 2003.

During March--July 2003, an epidemic of severe acute respiratory syndrome (SARS) in Beijing, China, accounted for 2,521 probable cases (attack rate: 19 per 100,000 population). To control the epidemic, public health officials initiated enhanced surveillance, isolation of SARS patients, use of personal protective equipment (PPE) by health-care workers, and quarantine of contacts of known SARS patients. Approximately 30,000 Beijing residents were quarantined in their homes or quarantine sites. To guide future quarantine policy, the Chinese Field Epidemiology Training Program (China FETP) of the Chinese Center for Disease Control and Prevention (China CDC) conducted a survey to estimate the risk for acquiring SARS among quarantined residents of Haidian District (2001 population: 2.24 million), Beijing, in May 2003, 1 month after the epidemic peaked. This report summarizes the results of that survey, which indicate that, as a component of a comprehensive SARS-control program, quarantine should be limited to persons who have contact with an actively ill SARS patient in the home or hospital, allowing for better focus of resources in future outbreaks.

China↗
PubMed1999

Ebola (subtype Reston) virus among quarantined nonhuman primates recently imported from the Philippines to the United States.

In April 1996, laboratory testing of imported nonhuman primates (as mandated by quarantine regulations) identified 2 cynomolgus macaques (Macaca fascicularis) infected with Ebola (subtype Reston) virus in a US-registered quarantine facility. The animals were part of a shipment of 100 nonhuman primates recently imported from the Philippines. Two additional infected animals, who were thought to be in the incubation phase, were identified among the remaining 48 animals in the affected quarantine room. The other 50 macaques, who had been held in a separate isolation room, remained asymptomatic, and none of these animals seroconverted during an extended quarantine period. Due to the rigorous routine safety precautions, the facility personnel had no unprotected exposures and remained asymptomatic, and no one seroconverted. The mandatory quarantine and laboratory testing requirements, put in place after the original Reston outbreak in 1989-1990, were effective for detecting and containing Ebola virus infection in newly imported nonhuman primates and minimizing potential human transmission.

Animals↗
PubMedDate not supplied

The experience of quarantine for individuals affected by SARS in Toronto.

OBJECTIVE: The purpose of this study was to explore the experience of home quarantine during the severe acute respiratory syndrome (SARS) outbreak in Toronto in 2003. DESIGN: Qualitative descriptive design. SAMPLE: Stratified random sampling techniques were used to generate a list of potential participants, who varied in terms of gender and closeness of exposure to someone with suspected SARS (contact level). Twenty-one individuals participated in the study. MEASUREMENTS: All interviews were audiotaped and followed a semistructured interview guide. Participants were invited to describe their experience of quarantine in detail including their advice for Public Health. RESULTS: The experience followed a trajectory of stages beginning before quarantine and ending after quarantine. Despite individual differences, common themes of uncertainty, isolation, and coping intersected the data. CONCLUSIONS: Public Health has a dual role of monitoring compliance and providing support to people in quarantine. This study has implications for public health policy and practice in planning for future public health emergencies in terms of the information and the resources required to mount an effective response.

Adult↗
PubMed2006

Current trends in quarantine entomology.

With world trade in agricultural commodities increasing, the introduction of exotic insects into new areas where they become pests will increase. The development and application of quarantine treatments or other mitigation approaches to prevent pest introduction in traded commodities raise many research and regulatory issues. The probit 9 standard for quarantine treatment efficacy has given way to risk-based alternatives. Varietal testing may have merit for some treatments or commodities but not for others. Development of generic treatments to control broad groups of insects or insects in all commodities can expedite new trade in agricultural products. Area-wide pest management programs lower pest levels before harvest and improve the quarantine security provided by any postharvest treatments. Systems approaches capitalize on cumulative pest mortality from multiple control components to achieve quarantine security in an exported commodity. Certain quarantine treatment technologies such as irradiation are not universally accepted, which is slowing their adoption. Standardized phytosanitary measures and research protocols are needed to improve the flow of information when countries propose to trade in a regulated commodity.

Agriculture↗
PubMed1998

Risk analysis of quarantine station performance: a case study of the importation of equine infectious anemia virus-infected horses into California.

We examined the risk of importing and mistakenly releasing equine infectious anemia virus (EIAV)-infected horses into California. A computer simulation model was constructed to evaluate current and alternative quarantine station procedures; 150,000 iterations were performed to simulate 15 different scenarios of 10,000 horses imported into the state over a 14-year period. Simulation results showed that under current conditions of low EIAV prevalence in exporting countries, increasing the quarantine period would not decrease the number of EIAV-infected horses mistakenly released from quarantine. In a worst case scenario of high EIAV prevalence in exporting countries, the model predicted 10 EIAV-infected horses would be imported, of these 1 or none would escape detection and would be released mistakenly if quarantine duration were 3 or 14 days, respectively. This model may be applied to other quarantine station situations for evaluating the importation risk for EIAV and other diseases.

Animals↗
PubMed1997

Quarantine for contaminated pathogens in transplantable human tumors or infections in tumor bearing mice.

To quarantine human tumor samples for transplantation into immune deficient mice or tumor xenograft lines established and introduced from other institutions, we performed isolated implantation and passaging of tumors in a vinyl isolator, and microbiological examinations of sentinel mice kept together with tumor bearing mice. We examined 105 pairs of sentinel mice used to quarantine 907 tumors, and found six cases of contamination or infection with Staphylococcus aureus, 20 cases with Pseudomonas aeruginosa and one case with mouse hepatitis virus (MHV). It was, however, possible that Mycoplasma pulmonis contamination was overlooked because the microbe had been isolated from tumors passaged after quarantine, even though the results of the quarantine of these tumors showed no sign of pathogens. Direct culture of tumors for the microbe was recommended to improve the quarantine system.

Animals↗
PubMed1996

Quarantine of aquatic animals in Australia.

Australia is free from many significant diseases of aquatic animals. Quarantine policies for aquatic animals and aquatic animal products are designed to meet the international trade obligations of Australia, while preventing the entry of pests and diseases. These policies are supported by measures to prevent the introduction of aquatic species which would have deleterious effects on the environment. The Australian approach to quarantine--utilising objective risk analysis, where possible--is more difficult to apply to aquatic species than to terrestrial animals, as it is hard to identify and quantify risks when much of the relevant disease and epidemiological information is unavailable. Other than ornamental fish, for which stringent quarantine restrictions apply, involving isolation in quarantine premises, there have been no commercial importations of live aquatic species into Australia over the past decade. The onerous requirements for detailed analysis of disease risks and environmental implications have tended to deter potential importers. For many years, specific controls--based on risk analysis--have also been placed on the importation of products such as oysters in the shell, salmonid products, and feeds and meals of aquatic animal origin. A major review of quarantine requirements has been commissioned.

Animal Feed↗
PubMed2003

Use of quarantine to prevent transmission of severe acute respiratory syndrome--Taiwan, 2003.

On July 5, 2003, Taiwan was removed from the World Health Organization (WHO) list of severe acute respiratory syndrome (SARS)-affected countries. As of July 9, a total of 671 probable cases of SARS had been reported in Taiwan. On February 21, the first identified SARS patient in Taiwan returned from travel to Guangdong Province, mainland China, by way of Hong Kong. Initial efforts to control SARS appeared to be effective; these efforts included isolation of suspect and probable SARS patients, use of personal protective equipment (PPE) for health-care workers (HCWs) and visitors, and quarantine of contacts of known SARS patients. However, beginning in mid-April, unrecognized cases of SARS led to a large nosocomial cluster and subsequent SARS-associated coronavirus transmission to other health-care facilities and community settings. In response to the growing epidemic, additional measures were taken to limit nosocomial and community transmission of SARS, including more widespread use of quarantine. By the end of the epidemic, 131,132 persons had been placed in quarantine, including 50,319 close contacts of SARS patients and 80,813 travelers from WHO-designated SARS-affected areas. This report describes the quarantine measures used in Taiwan and discusses the need for further evaluation of quarantine and other control measures used to prevent SARS.

Disease Outbreaks↗
PubMed2004

Isolation versus quarantine and alternative measures to control emerging infectious diseases.

In the past 25 years, the world has witnessed the emergence and re-emergence of many infectious diseases. In the early stages of their emergence, isolation and quarantine may be the only and last resort to effectively control infectious diseases when we are confronted with limited or no knowledge of a newly identified and previously unknown contagious disease, which causes a serious public health threat either locally or internationally. The article traces back the origins of isolation and quarantine; defines precisely the terms isolation and quarantine as they are currently used in the modern era; compare and contrast these terms; identifies some of the harmful consequences of applying quarantine measures; highlights considerations for the use of isolation and quarantine; and identifies alternative measures adopted by the world health community to respond to emerging and re-emerging health threats.

Communicable Disease Control↗
PubMed2005

[Cholera and quarantine in Kristiansand].

UNLABELLED: BACKGROUND AND MATERIAL: Cholera was the horror disease in Norwegian cities in the 18th century. The City of Kristiansand had a quarantine station and hospital at Odderøy island from 1804. We have studied the quarantine organisation and compared the number of cholera deaths in different cities along the coast. RESULTS: Drammen is comparable to Kristiansand and had many visiting trading ships. During 1832-33, 1833 and 1857 the Drammen community had registered 544 cholera patients; 336 died. Kristiansand had a total of only 15 deaths (1833, 1853 and 1866), the quarantine hospital included. Also compared to other cities, Kristiansand had few deaths. INTERPRETATION: The reason for the better cholera statistics in Kristiansand is probably the quarantine station and hospital at Odderøy island (1804). The city's health authorities had efficient routines and knowledge, probably adopted from the quarantine station and the hospital.

Cholera↗